MEDICARE: PHILIP M. SCHWARTZ, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	22D101136801	NJ

General Provider Information

NPI Number	:	1558468645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILIP M. SCHWARTZ, P.A.

Provider Business Mailing Address
First Line	:	339 GODWIN AVE
Second Line	:
City	:	MIDLAND PARK
State	:	NJ
Zip	:	07432-1533
Country	:	US
Telephone Number	:	201-652-7110
Fax Number	:	201-652-8983

Provider Business Practice Location Address
First Line	:	339 GODWIN AVE
Second Line	:
City	:	MIDLAND PARK
State	:	NJ
Zip	:	07432-1533
Country	:	US
Telephone Number	:	201-652-7110
Fax Number	:	201-652-8983

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PHILIP M SCHWARTZ
Credential	:	D.M.D.
Telephone Number	:	201-652-7110

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/21/2022

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